Abstract
On March 11th 2020, the World Health Organization characterised COVID-19 as a pandemic. Responses to containing the spread of the virus have relied heavily on policies involving restricting contact between people. Evolving policies regarding shielding and individual choices about restricting social contact will rely heavily on perceived risk of poor outcomes from COVID-19. In order to make informed decisions, both individual and collective, good predictive models are required. For outcomes related to an infectious disease, the performance of any risk prediction model will depend heavily on the underlying prevalence of infection in the population of interest. Incorporating measures of how this changes over time may result in important improvements in prediction model performance. This protocol reports details of a planned study to explore the extent to which incorporating time-varying measures of infection burden over time improves the quality of risk prediction models for COVID-19 death in a large population of adult patients in England. To achieve this aim, we will compare the performance of different modelling approaches to risk prediction, including static cohort approaches typically used in chronic disease settings and landmarking approaches incorporating time-varying measures of infection prevalence and policy change, using COVID-19 related deaths data linked to longitudinal primary care electronic health records data within the OpenSAFELY secure analytics platform.
Highlights
Background and aims OnMarch 11th 2020, the World Health Organization characterised COVID-19 as a pandemic after 118,000 cases and 4,291 deaths were reported in 114 countries[1]
Purpose of models The overarching aim of this study is to evaluate the utility of incorporating time-varying measures of infection burden into risk prediction models for COVID-19 related death
The study will use COVID-19 deaths data linked to longitudinal primary care electronic health records data within the OpenSAFELY secure analytics platform
Summary
March 11th 2020, the World Health Organization characterised COVID-19 as a pandemic after 118,000 cases and 4,291 deaths were reported in 114 countries[1]. As of 2 June, towards the end of the time period considered in this study, cases were over 6 million globally, with more than 300,000 deaths attributed to the virus[2]. A range of demographic factors and health conditions have been shown to be associated with poor outcomes from COVID-19, including COVID-19 related death. In the UK, the report released by Public Health England in June 2020 identified age as the strongest disparity in COVID-19 death, noting disparities between males and females, and higher risks among black and minority ethnic (BME) groups[4]. Various pre-existing conditions correlate with increased risk of poor outcomes including diabetes, respiratory disease and cancer[5]
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